Bannockburn man benefits from recovery programme

David Lewis

PATIENTS in Forth Valley undergoing bowel surgery are now being invited to take part in a special programme which speeds up recovery and cuts the time spent in hospital from several weeks to several days.

NHS Forth Valley said results so far have been impressive, with it consistently leading the way in the adoption of the National Enhanced Recovery Initiative.

As well as undergoing a detailed pre-operative assessment which looks at their current health and what they can do to improve it prior to surgery, the initiative includes a special preparation ‘boot camp’ which gives patients the chance to meet with other patients and discuss with staff what will happen before, during and after their operation.

These group sessions are designed to ensure patients are as prepared and knowledgeable as possible, are actively involved in their own care and feel empowered to ask questions at any point in their treatment.

The results are particularly encouraging for patients undergoing keyhole surgery for conditions such as bowel cancer, inflammatory bowel conditions (such as Crohn’s and Colitis) and diverticular disease.

Patients who are likely to require a stoma, ileostomy or colostomy bag are also invited to sessions before their operation where staff show them how to use and change the bags, answer any questions they may have and provide information.

So far more than 100 patients in the Forth Valley area have benefited from the initiative.

Linnet McGeever, NHS Forth Valley’s lead nurse for colorectal cancer and project manager for the recovery initiative, said: “Patients often find it difficult to take in information after major surgery so we now bring them in before their operation when they are more receptive and also find it reassuring to have the opportunity to ask questions and practice using different products in advance.”

The first 24 hours after major surgery is critical and a number of steps are taken to support recovery.

This includes getting patients back on their feet to reduce the risk of blood clots and chest infections, ensuring they are able to eat and drink within a day to reduce dehydration and removing devices such drips and catheters to reduce the risk of infections.

Patients are also given detailed information on what to expect once they go home and what warning signs to look out for.

Uniquely in NHS Forth Valley, patients taking part in the initiative are also given the direct number for the on-call surgeon who they can contact if they have any concerns or problems.

Bannockburn train driver David Lewis, who is in his 50s, underwent surgery on a Tuesday.

Two days later he left the ward and walked to meet his wife and parents in the restaurant at Forth Valley Royal Hospital. The next day he was allowed home.

Like other patients on the Enhanced Recovery Colorectal Initiative, David was given a number to contact the surgeon direct.

He said: “Because I got out so quickly it was good to have that number if I had any problems. I wanted to get back to normal as quickly as possible and get on with my life.

“I was driving my car two weeks later and I now do a six-mile walk at least once a week, sometimes two or three times.

“Three months after surgery I was back driving a train. I think I have been very lucky.

"When I meet people at work I say go and get your bowel screening done. I tell them not to be embarrassed about it, and to visit the doctor if you experience any problems.”

Mr Paul Hendry, colorectal surgeon and clinical lead for the recovery programme, added: “All our consultant surgeons who perform these operations are trained in keyhole surgery, many having undertaken advanced laparoscopic training in specialist centres around the world.

“We are probably the only hospital in Scotland which gives patients a direct link to the surgical team who can provide advice or arrange for them to come back up to the hospital to be seen in the Surgical Assessment Unit. So far, no one has abused this access as patients realise that this an emergency number and should only be used for serious issues or concerns.

“In many cases we are able to provide advice, reassurance or follow-up checks which ensure patients don’t have to come back into hospital unless they really need to.

"As a result, our readmission rate for this type of surgery is lower than the national average and patients suffer fewer complications as they know what to look out for and are encouraged to take action at an early stage.”

Patients are also followed up after surgery and those being treated for cancer are also offered an appointment with a Macmillan nurse within a fortnight.

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